JACKSON, Wis. – A former Washington County dentist has been sentenced to 4 ½ years in prison, convicted in March of health care fraud in a years-long scheme.
Scott Charmoli was the owner and sole dentist operating Jackson Family Dentistry in Jackson. In 2015, prosecutors said he began a years-long scheme to defraud dental insurance companies into paying for unnecessary crown procedures.
Charmoli aggressively sold crowns to patients and then intentionally broke their teeth with his drill in order to convince the insurance companies to pay for the crowns, prosecutors said. A federal jury found him guilty of five counts of health care fraud and two counts of making false statements to the insurance companies.
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Evidence at trial indicated that Charmoli performed far more crowns than most dentists in Wisconsin, ranking in, or above, the 95th percentile of crowns performed each year from 2016 to 2019. The evidence also showed that Charmoli billed over $4.2 million for crown procedures between 2016 and 2019, and that he performed more than 700 crowns each year from 2015 to 2019. In each of 2015 and 2016, Charmoli performed over 1,000 crown procedures.
Prosecutors said evidence also showed that, in addition to submitting x-rays to insurance companies of damage Charmoli himself had caused, Charmoli made false statements to dental insurers when they denied initial claims for crown coverage.
Charmoli benefited significantly from his scheme, prosecutors said. As part of his sentence, Charmoli already has been ordered to pay more than $1 million in forfeiture. He also will be responsible for reimbursing insurance companies and reimbursing patients who received fraudulent crowns for their out-of-pocket expenses.
In addition, Charmoli is the subject of several malpractice lawsuits brought by former patients.